The Body in Adolescence: Psychic Isolation and Physical Symptoms examines the affective experience of psychic isolation as an important and painful element of adolescent development. Mary Brady begins by discussing how psychic isolation, combined with the intensity of adolescent processes, can leave adolescents unable to articulate their experience. She then shows how the therapist can understand and help adolescents whose difficulty with articulation and symbolization can leave them vulnerable to breakdown into physical bodily symptoms.
This book introduces fresh ideas about adolescent development in the first chapter. Subsequent chapters include clinical essays involving adolescent patients presenting with bodily expressions such as anorexia, bulimia, cutting, substance abuse, and suicide attempts. Attention is also paid to adolescents’ use of social media in relation to these bodily symptoms – such as their use of on-line ‘pro-ana’ or cutting sites. Clinicians can feel challenged or even stymied when presented with their adolescent patient’s fresh cut or recent episode of binge drinking. Brady uses Bion’s conceptualization of containment and the balance of psychotic versus integrative parts of the personality to examine the emergence of concrete bodily symptoms in adolescence.
Throughout, Mary Brady offers ways of understanding and empathically engaging with adolescents. This book is essential reading for psychoanalysts and psychotherapists who treat adolescents and other patients with physical symptoms, as well as other readers with an interest in the psychoanalytic understanding of these issues.
Table of Contents
Foreword. Acknowledgements. Introduction. "Unjoined persons": psychic isolation in adolescence and its relation to bodily symptoms. Invisibility and insubstantiality in an anorexic adolescent: phenomenology and dynamics. Cutting the silence: initial, impulsive self-cutting in adolescence. Substance abuse in an adolescent boy: waking the object. "High up on bar stools": manic defenses and an oblivious object in a late adolescent. Sexuality unreceived and adolescent suicide . ‘Pro-ana’ web sites through an adolescent development lens.
Mary T. Brady is a psychoanalyst and clinical psychologist. She is in the private practice of psychoanalysis, psychotherapy and consultation in San Francisco. She is on the Faculty of the San Francisco Center for Psychoanalysis. She is a Member of the International Psychoanalytic Association and the American Psychoanalytic Association. She has published widely on adolescence and bodily symptoms. In 2010 she won the American Psychoanalytic Association Ralph Roughton Award for her paper ‘"Sometimes we are prejudiced against ourselves": Internalized and external homophobia in the treatment of an adolescent boy’.
This book by Mary Brady is a matter of absolute necessity in the literature of Psychoanalysis. Presenting her own clinical experience with young people ‘of our times’ – in which the body is taken as the seat of conflict – we can see an experienced and dedicated analyst working sessions with adolescents who suffer from the most frequent presentations of their age: eating disorders, cutting and substance abuse.
With masterful tact, she shows us how clinical work with these developing individuals enlightens us as to the singularity of young people, the dynamics of family groups, as well as the characteristics of a culture which, inundating the senses, aids and abets psychic isolation. - Virginia Ungar, M.D., Training and Supervising Analyst, Buenos Aires Psychoanalytic Association.
This is a very fine book. It enormously extends the range of our understanding of disturbed adolescents. The author has great expertise and wisdom, and her beautiful clinical stories are also informed by serious scholarship. Her identification of the sense of psychic isolation felt at times by even the most ordinary- and ordinarily sociable – adolescents as a major issue in adolescent psychopathology, is clearly a breakthrough . She draws our attention to their attention to their bodies, and her descriptions of her tact and sensitivity with these very touchy wounded young people are a joy to read. – Anne Alvarez is a Consultant Child and Adolescent Psychotherapist, and retired Co-Convener of the Autism Service, Child and Family Department, of the Tavistock Clinic, London.
In this book Mary Brady puts her finger on two crucial areas of adolescent anxiety, each of which makes the other one worse. She finds that loneliness is almost universal; adolescents’ frenetic socialising is often a defence against this. The other is their preoccupations with their bodies whose rapid changes fill them with terror. Their bodies are the seat of projections of disturbing feelings and unconscious beliefs. Her clinical and literary illustrations bring this beautifully to life. As Bion would have it she has identified the selected facts in the crisis of adolescence. - Robin Anderson, Training and Supervising Analyst in Ault and Child Analysis at the Institute of Psychoanalysis, London; he was also Consultant Child Psychiatrist at the Tavistock Clinic where he was Head of the Adolescent Department.